PhRMA is challenging a CMS Medicaid prescription drug best price rule that it says "will harm patients and manufacturers alike." | Shutterstock

PhRMA Sues to Block Medicaid Best Price Change

Pharmaceutical Research and Manufacturers of America (PhRMA) has asked a federal judge to invalidate a federal regulation that would require drug makers, starting in January 2023, to include the full value of patient financial assistance in their Medicaid best price calculations, if the companies cannot ensure that health plans will not ultimately capture the benefit of the aid for themselves.

Medicaid best price is a component in determining 340B prices. The 340B ceiling price for a covered outpatient drug is equal to the average manufacturer price (AMP) from the preceding calendar quarter minus the Medicaid unit rebate amount (URA). Drug makers must offer deeper 340B discounts if best price is lower than the ceiling price as calculated above.

Pharmaceutical Research and Manufacturers of America (PhRMA) has asked a federal judge to invalidate a federal regulation that would require drug makers, starting in January 2023, to include the full value of patient financial assistance in their Medicaid best price calculations, if the companies cannot ensure that health plans will not ultimately capture the benefit of the aid for themselves.

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